A prospective study on early PET/CT scans during the first cycle of salvage chemotherapy for relapsed or refractory diffuse large B-cell lymphoma. Issue 1 (2nd January 2022)

• Record Type: Journal Article
• Authors: Cherng, Hua-Jay J.; Chuang, Hubert H.; Steiner, Raphael; Fayad, Luis; Strati, Paolo; Nair, Ranjit; Hagemeister, Fredrick; Nastoupil, Loretta J.; Lee, Hun Ju; Neelapu, Sattva S.; Flowers, Christopher R.; Samaniego, Felipe; Rodriguez, Maria; Macapinlac, Homer A.; Feng, Lei; Westin, Jason
• Is Part Of: Leukemia & lymphoma. Volume 63:Issue 1(2022)
• Page Start: 74
• Page End: 83
• Publication Date: 2022-01-02
• Subjects: Diffuse large B-cell lymphoma -- positron emission tomography/computed tomography -- end of treatment -- real-time response assessment -- salvage chemotherapy; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2021.1971223
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: Many patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) will not respond to platinum-containing salvage chemotherapy. Predicting treatment failure earlier could help clinicians minimize chemotherapy toxicities for non-responders in favor of other treatments. We conducted a pilot study where 2 early PET/CTs were obtained on days 4 (D4) and 21 (D21) of cycle 1 (C1) of salvage therapy for DLBCL. Twenty-five patients were enrolled and have evaluable data. Ten (40%) had an unplanned therapy change after C1 and before end-of-treatment (EOT) evaluation due to treatment failure on early PET/CT as interpreted by the treating physician. Early PET/CT response at D4 or D21 was not associated with EOT response in evaluable patients. Disease specific survival was longer for patients with a persistent response on both D4 and D21 ( p = 0.042). Early PET/CT may predict salvage chemotherapy failure and could inform future clinical trials investigating early therapy change to non-chemotherapy treatments.